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Dec 11, 2024 | 
healthaffairs.org | Sheela Ranganathan
In recent years, policymakers, regulators, and litigants have increased their focus on the practices of pharmacy benefit managers (PBMs) in response to the high cost of prescription drugs. Specifically, there has been heightened tension between the Federal Trade Commission (FTC) and the largest PBMs in the United States since 2022, when FTC launched an extensive investigation into potentially anticompetitive PBM practices.
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Nov 14, 2024 | 
healthaffairs.org | Zachary Baron |Andrew Twinamatsiko |Sheela Ranganathan
The recent election results will usher in sweeping changes for major federal health care policies, programs, and the courts. Donald Trump’s second term in office will diverge substantially from the policies supported by the Biden Administration and will enable the new Administration to pursue aggressive regulatory changes and other measures in the health care arena.
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Nov 5, 2024 | 
healthaffairs.org | Sheela Ranganathan
On September 30, 2024, a district judge in Florida held for the first time that lawsuits initiated by whistleblowers under the False Claims Act (FCA) are unconstitutional, dismissing a Medicare fraud case because the whistleblower was not a properly appointed federal officer under Article II of the U.S. Constitution. If affirmed by higher courts, the case could hamper efforts to address fraud and abuse in health care and limit how the federal government may protect public rights.
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Oct 15, 2024 | 
healthaffairs.org | Sheela Ranganathan
Post-Dobbs, many states enacted laws that criminalize and otherwise restrict access to abortion. Some of these laws, like the abortion ban in Texas, allow any person to bring a civil action to initiate an investigation and enforce the law. In response, over a dozen states have passed shield laws to enshrine protections against subpoenas for patients who travel to access legal abortions, their medical providers, and others who help them access care.
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Aug 22, 2024 | 
healthaffairs.org | Sheela Ranganathan |Zachary Baron
Since its bipartisan enactment in late December 2020, the No Surprises Act (NSA) has been championed as a significant victory for health care reform aimed at protecting consumers from the most pervasive out-of-network surprise medical bills and constraining overall health care costs.
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Jul 19, 2024 | 
healthaffairs.org | Zachary Baron |Sheela Ranganathan |Andrew Twinamatsiko |Sara Rosenbaum
During its 2024 term, the Supreme Court issued multiple decisions that fundamentally reshape the relationship between the branches of the federal government. Much attention has been paid to its decision in two consolidated cases, Loper Bright Enterprises v. Raimondo and Relentless v. Department of Commerce (collectively "Loper"), in which the Supreme Court effectively declared “Chevron deference” dead.
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Jul 15, 2024 | 
healthaffairs.org | Sheela Ranganathan
On May 23, 2024, two long-term care trade associations and three nursing homes jointly filed a lawsuit in Texas challenging a Biden Administration rule that set forth new staffing requirements for nursing homes. The case has been assigned to Judge Matthew Kacsmaryk, a Trump appointee who has invalidated many Biden Administration regulations, including protections for gay and transgender employees, and is well known for his nationwide ruling blocking federal approval of medication abortion.
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Jun 21, 2024 | 
healthaffairs.org | Andrew Twinamatsiko |Sheela Ranganathan
On June 13, 2024, the Supreme Court rejected a challenge to FDA’s approval of medication abortion, shunting aside one of the latest efforts to impede access to safe abortion after the Supreme Court abrogated the constitutional right to abortion in Dobbs v. Jackson Women’s Health organization.
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Jun 4, 2024 | 
healthaffairs.org | Sheela Ranganathan
On September 21, 2023, the Federal Trade Commission (FTC) brought a noteworthy challenge in federal court against a large anesthesia provider group and the private equity (PE) firm that created and invested in the group. FTC argued that because the PE firm’s consolidation strategy allowed the provider to monopolize hospital anesthesia services, patients were left with the burden of paying higher prices for those services across Texas. On May 13, 2024, Judge Kenneth M.
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May 22, 2024 | 
healthaffairs.org | Sheela Ranganathan
The No Surprises Act (NSA) was enacted in December 2020 to protect consumers from the most pervasive out-of-network surprise medical bills and constrain overall health care costs. To further those goals, the NSA established a requirement to provide consumers with transparent information about expected out-of-pocket costs for health care items and services prior to receiving care.
